Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 21495 | PR |
NPI | 1003336983 |
---|---|
Provider Name | Erika Yesenia Pineda |
First Address | San Juan, PR 00921-3004 |
Second Address | San Juan, PR 00936 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2017 |
Last Update Date | 10/06/2020 |